Neoreviews Subscribe to Pediatrics in Review
HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Take the CME quiz:
 Vol. 7 No. 9, September 2006
Right arrow E-Letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-Letters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bleiweis, M. S.
Right arrow Articles by Saidi, A.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Bleiweis, M. S.
Right arrow Articles by Saidi, A.

NeoReviews Vol.7 No.9 2006 e463
© 2006 American Academy of Pediatrics

Advances in Neonatal Cardiac Surgery

Historical Perspective and Current Status

Mark S. Bleiweis, MD*
Arwa Saidi, MB, BCh*

* Congenital Heart Center, University of Florida, Gainesville, Fla

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. Describe the developments that have allowed advances in neonatal cardiac surgery.
  2. Describe the diagnostic approach to hypoplastic left heart syndrome (HLHS).
  3. Delineate the preoperative management of the neonate who has HLHS.
  4. Describe the original Norwood procedure and subsequent modifications.
  5. Delineate the optimal therapy in the postoperative period for neonates who have a single ventricle.


   Introduction
 
Advances in the surgical and medical management of children who have congenital heart disease (CHD) have led to a dramatic improvement in overall survival and reduced the long-term sequelae of open-heart surgery. With improved survival and decreased morbidity over the past 2 decades, the early complete repair of complex congenital heart problems in preterm and low-birthweight neonates has gained wider acceptance. Cardiologists and cardiothoracic surgeons now consider and perform complete neonatal repair more frequently than palliative surgery in this patient population.

The treatment of hypoplastic left heart syndrome (HLHS) best illustrates the evolution of management strategies to improve survival and long-term outcome. A recent modification of the Norwood operation that involves a right ventricle-to-pulmonary artery conduit has led to much improved early postoperative stability and, in many centers, improved survival to a stage II superior cavopulmonary connection. A multidisciplinary team approach is required to provide the necessary care for this complex patient population.


   Historical Perspective
 
In 1938, Robert Gross at Children’s Hospital in Boston successfully ligated a patent ductus arteriosus, and this procedure—performed against the wishes of surgeon-in-chief William Ladd—opened the era of surgery for CHD. (1) Gross and Hufnagel performed detailed animal experiments to develop a technique for treatment of coarctation of the aorta that involves excision and end-to-end anastomosis. (2) Clarence Craaford of Stockholm, Sweden, had visited Gross to observe his experimental work, and in October 1944, Craaford and Nylin were the first . . . [Full Text of this Article]






HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Academy of Pediatrics.